ArticleInternational journal of emergency medicine2022
External ventricular drain placement is associated with lower mortality after intracerebral hemorrhage with intraventricular hemorrhage.
Article in International journal of emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Hemoglobin and Perihematomal Edema After Intracerebral Hemorrhage: A Post Hoc Analysis of the i-DEF Trial.Neurocritical care · 2026Trial
- Impact of initial disease severity and metabolic stress on mortality in patients with suspected external ventricular drain-associated infection.Neurosurgical review · 2026Article
- A 7-Point Risk Stratification Tool for EVD Placement in Acute Intracerebral Hemorrhage: A Multivariable Analysis and the Development of Novel Predictive Score (EVD-ICH Score).Asian journal of neurosurgery · 2026Article
- Lumbar drainage in intracerebral haemorrhage with intraventricular haemorrhage (DRAIN IVH): protocol for a multi-centre, randomised-controlled, two-arm, assessor-blinded trial.European stroke journal · 2026Article
- Patterns of care and outcomes following external ventricular drain placement: Insights from the England HES administrative data set.Brain & spine · 2026Article
- Predictors of prolonged mechanical ventilation after surgery for hypertensive basal ganglia intracerebral hemorrhage: a retrospective cohort study.Frontiers in medicine · 2026Article
- Article
- Risk factor analysis of long-term outcomes in patients with large intracerebral and intraventricular hemorrhage treated primarily with combined external ventricular drainage and intraventricular thrombolysis.European journal of medical research · 2025Article
- Serial Diffusion Tensor Imaging and Rate of Ventricular Blood Clearance in Patients with Intraventricular Hemorrhage.Neurocritical care · 2025Article
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsMany patients with intracerebral hemorrhage (ICH) develop intraventricular hemorrhage (IVH), which is associated with higher mortality and worse clinical outcome. External ventricular drains (EVDs) are often placed, but there is little data on how much patients benefit from this intervention. We explored the use, timing, and location of EVD in ICH patients and any association with clinical outcome.
resultsDuring the study period, 2870 patients presented with primary ICH, and 2486 were included in analyses. Overall, patients were 73 (± 13) years old; 54% were male, and 46% had associated IVH. An EVD was placed in 29% of patients with IVH and 4% of those without. IVH patients with EVD were younger (67 ± 13 vs 74 ± 13, p < 0.001), had larger IVH volumes (17 mL vs 8 mL, p < 0.001), and lower GCS scores (7 vs 10, p < 0.001), compared to those without EVD. Ninety-day mortality was available in 2486 (100%) patients, while 90-day mRS was available in 1673 (67.3%). In univariate analysis, EVD placement was associated with lower likelihood of 90-day mortality (53% vs 59%, p = 0.048) but higher likelihood of poor outcome (88% vs 85%, p < 0.001) in those for whom this was available. Those with poor outcomes underwent faster EVD placement (0.46 days vs. 0.96 days, p = 0.01). In multivariate analysis, EVD placement was associated with lower 90-day mortality (OR 0.19, 95% CI 0.053-0.657, p = 0.009), but not with lower odds of poor outcome (OR 1.64, 95% CI 0.508-5.309, p = 0.4). In multivariate analysis, days to EVD placement was associated with lower 90-day mortality (OR 0.69, 95% CI 0.49-0.96, p = 0.027).
conclusionIVH is relatively common after ICH. After controlling for potential confounds, EVD placement is associated with lower mortality, but not clearly with better neurologic outcome. In addition, more rapid EVD placement is associated with higher mortality, potentially reflecting early development of herniation or obstructive hydrocephalus.
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